Moniz Michelle H, Gavin Loretta E, Dalton Vanessa K
Department of Obstetrics and Gynecology, the Program on Women's Healthcare Effectiveness Research, and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
Obstet Gynecol. 2017 Nov;130(5):1121-1125. doi: 10.1097/AOG.0000000000002314.
Contraception is an essential health service for reducing unintended pregnancy rates, improving health outcomes, and reducing health care costs. However, contraceptive services may not consistently provide access to the full method mix and to patient-centered care. Improving the quality of contraceptive care is a critical strategy to improve contraceptive use, health outcomes, and the patient experience of care. We here describe the three National Quality Forum-endorsed performance measures for contraceptive care, which are intended to monitor 1) provision of most and moderately effective methods, 2) access to long-acting reversible contraception, and 3) provision of most and moderately effective methods and access to long-acting reversible contraception after childbirth. These contraceptive care measures are designed to ensure that contraceptive care is accessible and offers the full spectrum of methods. Payers, health care systems, public agencies, and researchers could all monitor these performance measures for different populations. We describe the crucial role of clinicians in disseminating and using the contraceptive care performance measures for quality improvement. We describe ongoing efforts to improve contraceptive care quality, including the development of measures to monitor other dimensions of quality such as the safety and patient-centeredness of care. Thirty-eight million women at risk of unintended pregnancy are counting on us to improve the quality of family planning care in the United States and ensure that all women have the resources and tools to make free, informed choices about whether and when to become pregnant.
避孕是一项重要的医疗服务,有助于降低意外怀孕率、改善健康状况并降低医疗成本。然而,避孕服务可能无法始终如一地提供全面的避孕方法组合以及以患者为中心的护理。提高避孕护理质量是提高避孕措施使用率、改善健康状况以及提升患者护理体验的关键策略。我们在此描述三项获得美国国家质量论坛认可的避孕护理绩效指标,旨在监测:1)提供最有效和中等有效的避孕方法;2)提供长效可逆避孕方法;3)产后提供最有效和中等有效的避孕方法以及长效可逆避孕方法。这些避孕护理指标旨在确保避孕护理易于获得,并提供全面的避孕方法。支付方、医疗保健系统、公共机构和研究人员都可以针对不同人群监测这些绩效指标。我们描述了临床医生在传播和使用避孕护理绩效指标以改善质量方面的关键作用。我们还描述了为提高避孕护理质量而正在进行的努力,包括制定措施以监测质量的其他维度,如护理的安全性和以患者为中心的程度。在美国,3800万面临意外怀孕风险的女性指望我们提高计划生育护理的质量,并确保所有女性都有资源和工具来自由、明智地选择是否以及何时怀孕。